Zusammenfassung
Der folgende Artikel beschreibt spezielle Aspekte des anästhesiologischen Vorgehens im Rahmen von elektiven sowie notfallmäßigen Operationen abdomineller Aortenaneurysmen, die im klinischen Alltag häufig zu Unsicherheiten und Diskussionen führen. Beginnend von den präoperativen Vorbereitungen des Patienten und der Auswahl des idealen Anästhesieverfahrens, über den Sinn von zusätzlichem intraoperativem Monitoring bis hin zum intraoperativen Management der Hämodynamik und der Blutgerinnung sowie den Möglichkeiten der Nephroprotektion und der notfallmäßigen Versorgung des Patienten mit rupturiertem Aortenaneurysma wird die aktuelle Studienlage dargestellt. Soweit wie möglich werden daraus Empfehlungen für eine optimale anästhesiologische Therapie abgeleitet.
Abstract
The following article describes several aspects of the anesthetic management of patients presenting for elective or emergency surgery of an abdominal aortic aneurysm that frequently lead to uncertainties and discussions in the clinical routine. We present the current state of relevant studies and guidelines regarding the preoperative evaluation, the choice of the ideal anesthetic technique, the significance of additional intraoperative monitoring, hemodynamic and coagulation management as well as possible options of nephroprotection and the anesthetic management of ruptured abdominal aortic aneurysms. If possible, some recommendations for the optimal anesthetic management of these patients are derived from the results of current studies.
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J. Knapp und A. Walther geben an, dass kein Interessenkonflikt besteht.
Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.
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Knapp, J., Walther, A. Anästhesiologisches Management des abdominellen Aortenaneurysmas. Gefässchirurgie 23, 136–144 (2018). https://doi.org/10.1007/s00772-018-0375-y
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DOI: https://doi.org/10.1007/s00772-018-0375-y
Schlüsselwörter
- Abdominelles Aortenaneurysma
- Anästhesie
- Perioperatives Management
- Intraoperatives Monitoring
- Endovaskuläre Therapie